decisionhealth Newsletters, Part B News - 2023 Issue 1 (January)
E/M codes in ED top list of independent dispute resolution services
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Article Overview
This article reviews a federal report on independent dispute resolution activity tied to the No Surprises Act and highlights the service categories most often involved in disputes during the second and third quarters of 2022. It is useful for emergency medicine, revenue cycle, and medical coding professionals who want a high-level view of how disputed services were distributed across major specialty areas and time periods.
Why This Topic Matters
Understanding which service categories and code groups most often appear in independent dispute resolution can help coding, billing, compliance, and contract teams monitor dispute trends and assess where payment disagreements are concentrated. The article also situates the discussion within a CMS-reported federal process affecting out-of-network emergency and non-emergency services.
What You Will Learn
- What the independent dispute resolution process is within the No Surprises Act framework
- Which broad service categories were most frequently associated with disputes in the reported period
- How the report compares dispute activity across the covered quarters
- What types of specialty service groups were highlighted in the federal summary
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle professionals
- Compliance staff
- Emergency department administrators
- Payer contracting teams
Codes Discussed
Code Ranges Discussed
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